Caffeine abstention in the management of anxiety disorders

1989 ◽  
Vol 19 (1) ◽  
pp. 211-214 ◽  
Author(s):  
M. S. Bruce ◽  
M. Lader
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Increased Sensitivity

SynopsisCaffeine toxicity remains a rarely reported condition, which may mimic anxiety disorders. Anxiety disorder patients do not consume toxic amounts of caffeine. However, increased sensitivity to caffeine in these patients has been suggested as contributing to their symptoms. Six cases of anxiety disorder are presented who improved with only caffeine abstention, and remained well for at least a six-month follow-up period.

Characteristics of Parent- and Child-Reported Anxiety in Psychostimulant Medication Naïve, Clinically Referred Children with Attention Deficit Hyperactivity Disorder, Combined Type (ADHD-CT)

2002 ◽  
Vol 36 (2) ◽  
pp. 234-239 ◽  
Author(s):  
Alasdair Vance ◽  
Jan Costin ◽  
Rebecca Barnett ◽  
Ernest Luk ◽  
Paul Maruff ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Child Anxiety ◽  
Parent Report ◽  
School Age Children ◽  
Systematic Research ◽  
Child Report ◽  
Hyperactivity Disorder ◽  
Primary School Age

Objective: Anxiety is a frequent comorbid condition in referred primary school-age children with attention deficit hyperactivity disorder, combined type (ADHD-CT), yet there has been relatively little systematic research of the nature of this comorbid anxiety. We describe the characteristics of parent-reported child anxiety disorders and child-reported anxiety disorders in primary school-age children with ADHD-CT. Method: A cross-sectional study of 75 clinically-referred psychostimulant medication naïve children with ADHD-CT examining separately parent and child reports of anxiety, defined categorically and dimensionally. A two-year follow up of 12 children with parent-reported child anxiety and 12 children with child-reported anxiety was also completed. Results: There was no significant association between the child and parent reports of anxiety. Generalized anxiety disorder (GAD), separation anxiety disorder (SAD), specific phobia (SpPh) and social phobia (SoPh) were the most common anxiety disorder diagnoses reported by parents and children. Two-year follow-up data revealed no decrease in the parent report but a significant decrease in the child report of anxiety disorders. Conclusions: The dissonance between the parent report of child anxiety and the child report of anxiety, emphasizes the importance of careful and thorough clinical assessment of the child's perspective. The nature of parent-reported child anxiety and children's self-report of anxiety requires further systematic research.

Stresspac: A Controlled Trial of a Self-Help Package for the Anxiety Disorders

1995 ◽  
Vol 23 (2) ◽  
pp. 89-107 ◽  
Author(s):  
Jim White
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Controlled Trial ◽  
Individual Therapy ◽  
Anxiety Management ◽  
Ways Of Coping ◽  
Self Help ◽  
Management Advice ◽  
Post Therapy

In order to test the efficacy of a self-help anxiety management package, sixty-two individuals meeting DSM-III-R criteria for an anxiety disorder were randomly allocated to one of three conditions: Stresspac patients were given a self-help/information package. Advice only patients were offered verbal advice on ways of coping with anxiety. Patients in both conditions were seen on one occasion shortly after referral for assessment and management advice. They were then placed back on the waiting list for a three month period. Patients in the No intervention condition also completed measures during this time. They were not seen until the end of this period when formal assessment took place. All patients were then followed through individual therapy and to 12 month follow-up. Results clearly support the superiority of the Stresspac condition after the waiting period, at post therapy and at follow-up on a range of measures. Possible explanations for the results are discussed.

Anxiety disorders and the onset of depression among adults in the community

2002 ◽  
Vol 32 (6) ◽  
pp. 1121-1124 ◽  
Author(s):  
RENEE D. GOODWIN
Keyword(s):  
Anxiety Disorder ◽  
Major Depression ◽  
Anxiety Disorders ◽  
Panic Attack ◽  
Panic Attacks ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Sociodemographic Differences ◽  
Co Morbidity

Objective. To determine the association between anxiety disorders, panic attack and the risk of major depression among adults in the community.Method. Data were drawn from the Epidemiologic Catchment Area Program survey waves 1 (N = 20291) and 2 (N = 15849). Multivariate logistic regression analyses were used to determine the risk of incident major depression at 12-month follow-up (wave 2) associated with each anxiety disorder and panic attacks assessed at wave 1, adjusting for differences in sociodemographic characteristics, and then controlling simultaneously for all anxiety disorders, and other psychiatric co-morbidity.Results. Specific phobia (OR = 1.7 (1.6, 1.8)), agoraphobia (OR = 2.3 (2.2, 2.5)), obsessive–compulsive disorder (OR = 5.4 (5.0, 5.8)) and panic attack (OR = 1.9 (1.8, 2.1)) each made an independent contribution to the risk of major depression, which persisted after adjusting simultaneously for sociodemographic differences and other psychiatric co-morbidity. Conclusions. Each anxiety disorder and panic attacks appear to confer an independent risk for the onset of major depression within 12-months among adults in the community. Understanding the key role played by anxiety in depression onset is needed for prevention strategies.

scholarly journals The efficacy and safety of 'Antianxiety Granule' for anxiety disorder: A multicentre, randomized, double-blind, placebo-controlled, parallel-group trial

2019 ◽  
Author(s):  
Zhongwei Sha ◽  
Yiping Hou ◽  
Chunchun Xue ◽  
Ou Li ◽  
Zhimin Li ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Anxiety Disorders ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Parallel Group ◽  
Parallel Group Trial ◽  
Group Trial

Abstract Abstract Background: Anxiety disorders are the most prevalent class of lifetime disorders in China, and generalized anxiety disorder (GAD) is one of the most common but frequently overlooked anxiety disorders. Conventional pharmacological treatments for GAD have varying degrees of side effects, dependency, and/or withdrawal syndromes. Traditional Chinese Medicine (TCM) therapy is considered a valuable therapeutic option for anxiety disorders and a potentially effective technique to reduce the side effects associated with antipsychotic drugs. This trial aimed to evaluate the clinical efficacy and safety of Antianxiety Granule, a granular Chinese medicine compound, for GAD. Methods/Design: The current work is a multicentre, randomized, double-blind, placebo-controlled, parallel-group clinical trial with a 6-week treatment schedule. The study consists of three periods: a 1- to 7-day screening period, a 6-week primary treatment period, and a 1-week follow-up period. Follow-up assessments will be conducted one week after the last visit with a face-to-face interview or by telephone. The clinical efficacy of Antianxiety Granule for the treatment of GAD will be evaluated by examining the change in the Hamilton anxiety scale (HAMA) score, state-trait anxiety inventory (STAI) score, and TCM symptom scale in GAD patients who receive the daily TCM treatment. Moreover, an intention-to-treat (ITT) analysis will also be used in this randomized controlled trial (RCT). Discussion: Our study is a multicentre, randomized, double-blind, placebo-controlled, parallel-group trial to evaluate the safety and efficacy of Antianxiety Granule for the treatment of GAD. The results of this trial will provide valuable clinical evidence for the treatment of GAD. Trial registration: The trial was registered with Chinese Clinical Trial Registry (http://www.chictr.org.cn/showproj.aspx?proj=27210) under the registration number ChiCTR1800016039 on 8 May 2018. The study was approved by the Ethics Committee of the Shanghai Municipal Hospital of Traditional Chinese Medicine (2017SHL-KY-14). Keywords: Generalized anxiety disorder (GAD), Traditional Chinese Medicine (TCM), RCT, Efficacy, Safety

A longitudinal examination of psychosocial impairment across the anxiety disorders

2013 ◽  
Vol 44 (8) ◽  
pp. 1691-1700 ◽  
Author(s):  
K. Naragon-Gainey ◽  
M. W. Gallagher ◽  
T. A. Brown
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Anxiety Disorders ◽  
Behavioral Therapy ◽  
Clinical Sample ◽  
Anxiety Symptoms ◽  
Latent Growth ◽  
Psychosocial Impairment ◽  
Co Morbidity

BackgroundAnxiety disorders are highly prevalent disorders associated with substantial psychosocial impairment, but few studies have examined impairment within specific anxiety disorders. Furthermore, it is unclear how change in different types of anxiety has an impact on change in impairment, particularly given high rates of co-morbidity. The current study assessed the temporal associations of impairment and symptoms of three common anxiety disorders in a large, diagnostically heterogeneous clinical sample.MethodData were collected from 606 treatment-seeking individuals at an anxiety clinic, most of whom subsequently enrolled in cognitive-behavioral therapy. Symptoms of panic, social anxiety and generalized anxiety disorder (GAD), as well as levels of impairment, were assessed three times over 2 years. In addition to examining levels of impairment across diagnostic groups, latent growth modeling was used to evaluate the longitudinal associations of anxiety symptoms and impairment.ResultsThose with a principal diagnosis of GAD reported higher levels of impairment in some domains at baseline; however, at follow-up assessments individuals with social anxiety disorder reported greater impairment than those with panic disorder. Anxiety symptoms and impairment both declined over time. Change in all three anxiety symptoms was closely associated with change in impairment, but only GAD remained a significant (positive) predictor of change in impairment after accounting for co-morbidity.ConclusionsImpairment and all three anxiety disorders were closely associated, both cross-sectionally and longitudinally. Because change in GAD was most specifically related to change in impairment, treatment for those with multiple anxiety disorders could focus on treating GAD symptoms first or treating transdiagnostic processes.

scholarly journals Mood and anxiety disorders and their association with non-medical prescription opioid use and prescription opioid-use disorder: longitudinal evidence from the National Epidemiologic Study on Alcohol and Related Conditions

2011 ◽  
Vol 42 (6) ◽  
pp. 1261-1272 ◽  
Author(s):  
S. S. Martins ◽  
M. C. Fenton ◽  
K. M. Keyes ◽  
C. Blanco ◽  
H. Zhu ◽  
...  
Keyword(s):  
Substance Use ◽  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Mood Disorders ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Medical Prescription ◽  
Self Medication ◽  
Prescription Opioid Use

BackgroundNon-medical use of prescription opioids represents a national public health concern of growing importance. Mood and anxiety disorders are highly associated with non-medical prescription opioid use. The authors examined longitudinal associations between non-medical prescription opioid use and opioid disorder due to non-medical opioid use and mood/anxiety disorders in a national sample, examining evidence for precipitation, self-medication and general shared vulnerability as pathways between disorders.MethodData were drawn from face-to-face surveys of 34 653 adult participants in waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Logistic regression models explored the temporal sequence and evidence for the hypothesized pathways.ResultsBaseline lifetime non-medical prescription opioid use was associated with incidence of any mood disorder, major depressive disorder (MDD), bipolar disorder, any anxiety disorder and generalized anxiety disorder (GAD in wave 2, adjusted for baseline demographics, other substance use, and co-morbid mood/anxiety disorders). Lifetime opioid disorder was not associated with any incident mood/anxiety disorders. All baseline lifetime mood disorders and GAD were associated with incident non-medical prescription opioid use at follow-up, adjusted for demographics, co-morbid mood/anxiety disorders, and other substance use. Baseline lifetime mood disorders, MDD, dysthymia and panic disorder were associated with incident opioid disorder due to non-medical prescription opioid use at follow-up, adjusted for the same covariates.ConclusionsThese results suggest that precipitation, self-medication as well as shared vulnerability are all viable pathways between non-medical prescription opioid use and opioid disorder due to non-medical opioid use and mood/anxiety disorders.

scholarly journals The association of personality disorders with the prospective 7-year course of anxiety disorders

2010 ◽  
Vol 41 (5) ◽  
pp. 1019-1028 ◽  
Author(s):  
E. B. Ansell ◽  
A. Pinto ◽  
M. O. Edelen ◽  
J. C. Markowitz ◽  
C. A. Sanislow ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Personality Disorders ◽  
Prognostic Significance ◽  
Post Traumatic Stress ◽  
Structured Interviews ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

BackgroundThis study prospectively examined the natural clinical course of six anxiety disorders over 7 years of follow-up in individuals with personality disorders (PDs) and/or major depressive disorder. Rates of remission, relapse, new episode onset and chronicity of anxiety disorders were examined for specific associations with PDs.MethodParticipants were 499 patients with anxiety disorders in the Collaborative Longitudinal Personality Disorders Study, who were assessed with structured interviews for psychiatric disorders at yearly intervals throughout 7 years of follow-up. These data were used to determine probabilities of changes in disorder status for social phobia (SP), generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), panic disorder and panic disorder with agoraphobia.ResultsEstimated remission rates for anxiety disorders in this study group ranged from 73% to 94%. For those patients who remitted from an anxiety disorder, relapse rates ranged from 34% to 67%. Rates for new episode onsets of anxiety disorders ranged from 3% to 17%. Specific PDs demonstrated associations with remission, relapse, new episode onsets and chronicity of anxiety disorders. Associations were identified between schizotypal PD with course of SP, PTSD and GAD; avoidant PD with course of SP and OCD; obsessive-compulsive PD with course of GAD, OCD, and agoraphobia; and borderline PD with course of OCD, GAD and panic with agoraphobia.ConclusionsFindings suggest that specific PD diagnoses have negative prognostic significance for the course of anxiety disorders underscoring the importance of assessing and considering PD diagnoses in patients with anxiety disorders.

scholarly journals The efficacy and safety of 'Antianxiety Granule' for anxiety disorder: A multicentre, randomized, double-blind, placebo-controlled, parallel-group trial

2019 ◽  
Author(s):  
Zhongwei Sha ◽  
Yiping Hou ◽  
Chunchun Xue ◽  
Ou Li ◽  
Zhimin Li ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Chinese Medicine ◽  
Traditional Chinese Medicine ◽  
Anxiety Disorders ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Parallel Group ◽  
Parallel Group Trial ◽  
Group Trial

Abstract Background: Anxiety disorders are the most prevalent class of lifetime disorders in China, and generalized anxiety disorder (GAD) is one of the most common but frequently overlooked anxiety disorders. Conventional pharmacological treatments for GAD have varying degrees of side effects, dependency, and/or withdrawal syndromes. Traditional Chinese Medicine (TCM) therapy is considered a valuable therapeutic option for anxiety disorders and a potentially effective technique to reduce the side effects associated with antipsychotic drugs. This trial aimed to evaluate the clinical efficacy and safety of Antianxiety Granule, a granular Chinese medicine compound, for GAD. Methods/Design: The current work is a multicentre, randomized, double-blind, placebo-controlled, parallel-group clinical trial with a 6-week treatment schedule. The study consists of three periods: a 1- to 7-day screening period, a 6-week primary treatment period, and a 1-week follow-up period. Follow-up assessments will be conducted one week after the last visit with a face-to-face interview or by telephone. The clinical efficacy of Antianxiety Granule for the treatment of GAD will be evaluated by examining the change in the Hamilton anxiety scale (HAMA) score, state-trait anxiety inventory (STAI) score, and TCM symptom scale in GAD patients who receive the daily TCM treatment. Moreover, an intention-to-treat (ITT) analysis will also be used in this randomized controlled trial (RCT). Discussion: Our study is a multicentre, randomized, double-blind, placebo-controlled, parallel-group trial to evaluate the safety and efficacy of Antianxiety Granule for the treatment of GAD. The results of this trial will provide valuable clinical evidence for the treatment of GAD. Trial registration: The trial was registered with the Chinese Clinical Trial Registry (http://www.chictr.org.cn/showproj.aspx?proj=27210) under the registration number ChiCTR1800016039 on 8 May 2018. The study was approved by the Ethics Committee of the Shanghai Municipal Hospital of Traditional Chinese Medicine (2017SHL-KY-14). Keywords: Generalized anxiety disorder (GAD), Traditional Chinese Medicine (TCM), RCT, Efficacy, Safety

scholarly journals Enduring effects of psychological treatments for anxiety disorders: meta-analysis of follow-up studies

2018 ◽  
Vol 212 (6) ◽  
pp. 333-338 ◽  
Author(s):  
Borwin Bandelow ◽  
Anne Sagebiel ◽  
Michael Belz ◽  
Yvonne Görlich ◽  
Sophie Michaelis ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Anxiety Disorders ◽  
Cognitive Behavioural Therapy ◽  
Psychological Treatment ◽  
Meta Analysis ◽  
Behavioural Therapy ◽  
Control Groups ◽  
Cognitive Behavioural ◽  
Significant Difference

BackgroundIt is a widespread opinion that after treatment with psychotherapy, patients with anxiety disorders maintain their gains beyond the active treatment period, whereas patients treated with medication soon experience a relapse after treatment termination.AimsWe aimed to provide evidence on whether enduring effects of psychotherapy differ from control groups.MethodWe searched 93 randomised controlled studies with 152 study arms of psychological treatment (cognitive–behavioural therapy or other psychotherapies) for panic disorder, generalised anxiety disorder and social anxiety disorder that included follow-up assessments. In a meta-analysis, pre-post effect sizes for end-point and all follow-up periods were calculated and compared with control groups (medication: n = 16 study arms; pill and psychological placebo groups: n = 17 study arms).ResultsGains with psychotherapy were maintained for up to 24 months. For cognitive–behavioural therapy, we observed a significant improvement over time. However, patients in the medication group remained stable during the treatment-free period, with no significant difference when compared with psychotherapy. Patients in the placebo group did not deteriorate during follow-up, but showed significantly worse outcomes than patients in cognitive–behavioural therapy.ConclusionsNot only psychotherapy, but also medications and, to a lesser extent, placebo conditions have enduring effects. Long-lasting treatment effects observed in the follow-up period may be superimposed by effects of spontaneous remission or regression to the mean.Declaration of interestIn the past 12 months and in the near future, Dr Bandelow has been/will be on the speakers/advisory board for Hexal, Mundipharma, Lilly, Lundbeck, Pfizer and Servier. Dr Wedekind was on the speakers' board of AstraZeneca, Essex Pharma, Lundbeck and Servier. All other authors have nothing to declare.

Improving the Recognition of Anxiety Disorders in Depressed Patients

CNS Spectrums ◽  
2006 ◽  
Vol 11 (S1) ◽  
pp. 2-4
Author(s):  
Iwona Chelminski
Keyword(s):  
Primary Care ◽  
Anxiety Disorder ◽  
Panic Disorder ◽  
Anxiety Disorders ◽  
Panic Attacks ◽  
Depressed Patients ◽  
Increased Risk ◽  
History Of ◽  
Primary Care Patients

There is considerable symptom overlap and high levels of comorbidity between anxiety disorders and depression. The recognition of this comorbidity has both academic interest and clinical significance. Epidemiological studies have demonstrated that depressed individuals with a history of anxiety disorders are at increased risk for hospitalization, suicide attempt, and greater impairment from the depression. These individuals also tend to have a more chronic course of depression, as observed in psychiatric patients, primary care patients, and epidemiological samples. Van Valkenberg and colleagues reported that depressed patients with anxiety had poorer outcome and greater psychosocial impairment than those without an anxiety disorder. In the National Institute of Mental Health Collaborative Depression Study, the presence of panic attacks predicted a lower rate of recovery during the first 2 years of the follow-up interval. Similarly, Grunhaus found poorer outcome in depressed patients with comorbid panic disorder than in depressed patients without panic. In an 8-month follow-up study, depressed primary care patients with a history of generalized anxiety disorder (GAD) or panic disorder were less likely to have recovered from their depressive episode.Gaynes and colleagues prospectively followed primary care patients with major depressive disorder (MDD) every 3 months for 1 year after their initial diagnostic evaluation. At baseline, half of the original 85 patients had a coexisting anxiety disorder, the most frequent being social phobia (n=38). Twelve months after intake, 68 of the patients were available for the final interview. Those with a comorbid anxiety disorder were significantly more likely to still be in an episode of depression (82% vs 57%; risk ratio=1.44; 95% CI 1.02-2.04), and they experienced more disability days during the course of the 12 months than the depressed patients without an anxiety disorder (67.1 days vs 27.5 days).

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